Ambulance costs can endanger lives: hundreds of euros for each call in Germany
Starting from January 2026, patients in North Rhine-Westphalia may face personal costs of up to hundreds of euros if an ambulance is called and there is no actual need for it. This change comes as a result of a dispute between health insurance companies and municipalities over what is known as 'empty calls'.
In the past, the costs of unnecessary ambulance trips were shared between health insurance companies and local authorities. In the future, these costs will not be covered by insurance companies, and patients may bear them. Estimates from the city of Essen suggest that typical fees could reach 267 euros. The fees will be charged to the patient in need of assistance, not to the person who calls emergency services.
Experts warn that high costs may prevent people from calling 112 in genuine emergencies. The elderly, chronically ill, and low-income individuals are the most at risk, as they may lose precious minutes in life-threatening situations such as heart attacks or strokes.
Studies indicate that rising personal costs reduce the use of emergency services and increase the likelihood of creating a two-tier ambulance system: wealthy individuals call for an ambulance immediately, while poor patients delay seeking care, leading to worse outcomes. This may also increase the pressure on general practitioners, emergency rooms, and on-call physician services.
Emergency doctors confirm that critical symptoms—such as chest pain, shortness of breath, neurological disturbances, severe bleeding, loss of consciousness, or serious accidents—should always prompt a call to emergency services regardless of cost. Experts point out that financial barriers are not the right solution, emphasizing the importance of better management, public education, and an effective recall system instead.